Anyone pushed hard enough, hit hard enough by life events in the most vulnerable areas of his beliefs and identity, can have a strong negative emotional reaction that translate into anxiety and depression, a very common combination. Although it takes a great deal of bad news to get them so down, high achievers are also vulnerable to the ups and down of life. The severity of these emotional reactions depends on the intensity of the trigger, its duration and the degree of hopelessness inflicted by it.
In high achievers, often the first symptom detected is an uncharacteristic decline of motivation--
a clear departure from their usual functional state. Gradually, if the problem persists long enough, they find that their confidence is waning. The innovative ideas they were famous for seem to dry up. They are overcome by an increasing, completely uncharacteristic, sense of hopelessness.
Because these feelings are new to them, often they do not recognize them as a reaction to the circumstances, but as a “weakness” and a sign of their own “inadequacy.” Their logic often tells them that one can’t possibly be well equipped to handle the job demands a few months ago and then, suddenly, be incapable of doing so a few months later. What has changed? They know just as much now as they did a few months ago. The only thing that changed is their emotional reaction and the way they now “feel” about things and about themselves.
Often, by this time, the depression and anxiety begins to take physical manifestations. They start having insomnia almost every night. Their appetite is diminished and they lose weight at a fast pace. Their shoulders slump and their backs stoop. All the lines of their faces are now pointing down. They forget to smile. They stop enjoying things they used to enjoy. These are changes a high achiever will often deny are happening, in the hope that they will soon find a way to make them go away. But they can’t find the way out because anxiety and depression affects the very emotional engines one needs to recover from anxiety and depression. What usually happens now is their emotions become engaged in a negative spiral they can’t escape on their own. They reach a point when they desperately need help. Usually at this point, someone in their family, most commonly the spouse, witnessing how their loved one is wasting away, finally sounds the alarm.
The high achievers will delay making the phone call to a psychiatrist not because they have something against psychiatrists in principle as long as other people need them, but because high achievers still convince themselves they are not “that bad.” Recognizing the magnitude of their emotional problem is regarded by them as a personal failure, and failure for high achievers is the biggest disaster imaginable. It is exactly what they spend all their lives finding creative ways of avoiding.
As you may imagine, by the time the high achievers find their way to the psychiatrist’s office to get help, usually with a great amount of nudging and diplomacy from their families, their symptoms have worsened significantly. That makes their recovery longer and more difficult. When I get a new high achiever patient, I know that we both will have to put a great deal of effort and care in getting him well.
My intervention in these cases is based on my Better Than Cured model. Using a combination of tools, from medication to cognitive behavior therapy, spirituality and life coaching, Better Than Cured has offered great results in helping my high achiever patient. Often, an anti-depressant/anti-anxiety medication is needed to stop the progression of symptoms (anxious feeling, hopelessness, insomnia, lack of appetite, etc.) and to start reversing them. The cognitive behavioral techniques help him learn to dominate anxiety by using the logic of his own mind. When he improves even more, we talk about insight, the driving forces of his motivation and how he relates to goals and ideals higher than himself through spirituality.
As my high achiever patient continues to feel better, he has more energy to go through the day. Getting up to go to work becomes less of an effort and the creative “juices” start flowing again. He feels more grounded and more insightful. This is usually the point when using life coaching tools we start talking about the practical steps he could take to manage the very problems that generated the emotional turmoil. Now that his mind is no longer clouded by excessive negative emotions, he can usually see many new ways out that were hidden from him before. He is now engaged on the positive spiral, where every positive step, builds on the previous one, helping him climb out from under the cloud of hopelessness. He gradually starts feeling more and more in control again—one of the most powerful antidotes against anxiety and depression.
Helping high achievers overcome their anxiety and depression is very rewarding for me. All my patients in this category have been exceptional people who found their way to wellness. Once they recover and become themselves again, it’s easy to understand how they achieved the successes they have achieved in their lives. Whether they have an unusual ability to interpret facts and to connect the dots when most people can make neither head nor tail of that information, or they have an uncanny ability to come up with solutions when most people have given up, or they have an extraordinary capacity to never give up facing rejections and setbacks, they are remarkably talented and creative people in their own fields of interest. Work and career for high achievers is even more important than for other people, the source of great satisfaction and pride, the skeleton on which their entire identity is built. This is why, when unable to perform at their usual high level at work, they feel their entire lives fall apart.
If you are a person in this category or know someone close like this, be aware of these issues. No one is immune to developing an anxiety and/or depression problem. Take corrective measures as early as you detect the signs. An early intervention leads to a faster recovery. Anxiety and depression are not character flaws. They are reactions to life is challenges or to internal struggle. They can be treated and resolved. When you have exhausted all the coping skills you usually have, and still feel anxious and depressed, do not hesitate to ask for help. It’s just like asking for a guide when you get lost in a new city. There is absolutely nothing wrong with it.
Thank you for reading this post. I am extremely interested in what you think about this issue. Your comments will help me better understand and help my patients. Please do not hesitate to write your opinions in the “comment” section below. Thank you.
I took all these pictures at Lotus Land, Santa Barbara, a very romantic property who belonged to Ganna Walska.


The three major groups of medications used to treat anxiety:


